addition to the task of overseeing the well-being of some five hundred patients within the state hospital complex. A demanding situation under the best of circumstances, and impossible without a capable staff. Marlowe often wished for a capable staff.
He was tall and lean, with a profile that might have made a good Holmes if the haphazardly trimmed beard and randomly combed black hair hadn’t more suggested Moriarty. His eyes were so deep a blue as to seem almost black; one patient had told him he looked like Lord Byron, but many patients had called him many names. In a three-piece suit Marlowe would have fit the TV-romantic ideal of the distinguished young physician; however, around the hospital he favored open-necked sport shirts of imaginative pattern, casual slacks, and scuffed Wallabies. The crepe soles of these last were generally overworn to one side, giving him almost a clubfooted stance, but tile corridors are not kind to feet, and Marlowe liked such comforts as were permitted.
He unlocked an outside door, stepped out to cut across a courtyard. The summer night was hot and still. Behind electrified grates, ultraviolet lamps lured nocturnal insects to their doom; harsh crackles made the only sound other than the soft crunch of gravel beneath Marlowe’s crepe soles. There was a full moon, hot and electric itself, and Marlowe knew he would get little rest this weekend.
There was sound again when he unlocked the door to South Unit’s admission ward. The door to a seclusion room stood open, and inside three attendants were just fastening the padded cuffs. Spread-eagled on the bed, a young black man struggled against the wrist and ankle restraints and screamed curses. At the end of the hall way, several of the ward patients hovered anxiously, until a nurse’s assistant shooed them back to bed.
An attendant handed Marlowe the commitment papers. He glanced through them: 2 3-year-old black male, combative and threatening to life and person of family and neighbors since last night, apparently hallucinating, claimed to be Satan released from Hell. Today fired shotgun at neighbor’s house, subdued by officers; involuntary commitment papers signed by family, no previous history of mental disorders.
Marlowe entered the seclusion room, studying his patient. His dress was flamboyant, his appearance well-groomed; he was lean but not emaciated, with prominent veins standing out from the straining muscles of his arms. Marlowe’s initial impression was psychotic drug reaction, probably angel dust or amphetamines.
“Mr. Stallings, my name is Dr Marlowe. I’m your physician, and I’d like to ask you a few questions.”
“I am His Satanic Majesty, Lucifer God, Son of the Sun, Prince of Darkness and Power! Ye who seek to chain me in the Pit shall be utterly cast down! Bow down to me and worship, or feed the flames of my wrath!”
Marlowe played his stethoscope across his heaving chest. “Anyone able to get a blood pressure?”
The ward nurse handed him a sheet. “Don’t know how good these vital stats are—he’s been abusive and combative since the deputies brought him in. He’s strong as a horse, I can tell you.”
“These are about what they recorded at Frederick County when they examined him,” Marlowe said. “We still don’t have a chart on him?”
“First admission to Graceland, Dr Marlowe.”
The patient shouted obscenities, ignoring Marlowe’s efforts to examine him. Verbal content was a jarring mixture of street slang and religious phrases, frankly delusional. There seemed little point in continuing with the examination at this point.
Marlowe turned to the ward nurse, who was showing anger despite her experience with abusive patients. “Thorazine, 100 mgm IM.”
Two attendants held the patient on his side, pants drawn down, while she gave him the injection. The graveyard shift would be coming on shortly, and they had work to finish before they could go off. Marlowe observed the familiar ritual in silence, studying his patient’s reactions.
“Just make sure his blood pressure doesn’t drop out,” he told them. “I’ll write out orders for another 100 IM PRN q 4 hours, if this doesn’t do it. I’ll finish my examination once he’s quiet.”
“Thank you, Doctor.”
Marlowe’s beeper summoned him while he was writing orders. “That’s North Unit. Could you dial that for me, please?” He took the phone from the attendant and wedged it under his chin; one hand holding a Styrofoam coffee cup, the other scribbling an admission note.
“Dr Marlowe, we have an unauthorized absence from North Unit. The patient is Billy Wilson. He is an involuntary admission.” Marlowe sipped his coffee. “Chronic schiz from Jefferson County? I’ve had him on